Exploring Combined Use of Continuous Glucose Monitoring and Anti‐Diabetes Medications on Glycaemic Control for People With Type 2 Diabetes Not Using Insulin

ABSTRACT Introduction Continuous glucose monitoring (CGM) offers a detailed view of glycaemic management, potentially enhancing the effectiveness of non‐insulin, anti‐diabetes medications. This study aimed to evaluate whether CGM use in combination with anti‐diabetes medications is associated with changes in A1c among people with type 2 diabetes not using insulin. Materials and Methods This was a retrospective, observational analysis of administrative claims and linked laboratory data from Optum's Clinformatics Data Mart database. The study observation period covered 01/07/2018 through 30/06/2023 with 6‐month baseline and follow‐up periods. CGM use in conjunction with ≥ 1 of five anti‐diabetes medication classes: metformin, sulfonylureas, sodium‐glucose cotransporter‐2 (SGLT2) inhibitors, dipeptidyl peptidase‐4 (DPP‐4) inhibitors and/or glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) was required. The primary outcome was change in A1c from baseline. Linear regression models tested the main and interaction effects of CGM and each anti‐diabetes medication. Results Overall, 52,394 CGM‐naïve adults with non‐insulin‐treated type 2 diabetes using anti‐diabetes medications were identified (4086 CGM users; 48,308 CGM non‐users). CGM use was associated with a –0.45% greater A1c change among CGM users compared to CGM non‐users ( p < 0.0001). After adjusting for covariates, CGM users experienced greater A1c reductions vs. CGM non‐users with all medications, but statistically significant interactions showed that for DPP‐4 inhibitors, GLP‐1 RAs and sulfonylureas, there were greater decreases in A1c for CGM users vs. CGM non‐users who were taking the medication compared to CGM users vs. CGM non‐users who were not taking the medication. A1c change between CGM users vs. CGM non‐users did not vary by metformin or SGLT2 inhibitor use. Discussion The findings suggest that CGM use could augment the glycaemic benefits of anti‐diabetes medications in people with non‐insulin treated type 2 diabetes. These results support broader adoption of CGM.